CHEYENNE – As the projected deadline for health care workers to comply with a federal vaccine mandate approaches, Cheyenne Regional Medical Center and other medical facilities are having to grapple with what that means.

Some workers who continue to resist getting the COVID-19 vaccine may end up losing their jobs in the coming months, while some may leave voluntarily before that can happen.

Per rules laid out by the U.S. Centers for Medicare and Medicaid Services, or CMS, employees of health care facilities of any size must receive their first shot of the two-dose Pfizer or Moderna vaccines, or the one-dose Johnson & Johnson vaccine, by Dec. 6, and be fully vaccinated by Jan. 4.

Mandate rules set by the U.S. Occupational Safety and Health Administration, the federal labor and workplace agency known as OSHA, are currently stayed in the New Orleans-based 5th U.S. Circuit Court of Appeals.

But virtually every medical facility in Wyoming – hospitals, nursing homes, rural health clinics and others – that receives federal funding as reimbursement for caring for a patient must adhere to CMS’s rules requiring vaccination against COVID-19.

Eric Boley, president of the Wyoming Hospital Association, said there are still unknowns with vaccine mandates and what will happen after the deadlines. Generally, though, he expects CMS will send surveyors to medical facilities to check for compliance. The agency can immediately begin fining facilities $14,000 per employee for noncompliance, he said.

“(The facilities) will have a chance to come into compliance, and if we don’t come into compliance, then they could just withhold all of our federal funding, which would, in essence, close the doors of most facilities, because they wouldn’t be able to afford to take care of patients anymore,” Boley said.

CMS can also decertify medical facilities, taking away their ability to care for patients.

“They have a pretty heavy hammer that they can use,” Boley said.

While the OSHA rules require employees who wish not to get the vaccine to instead submit to regular testing, Boley said, the CMS rules don’t allow this. Instead, employees can apply for medical or religious exemptions.

Currently, 81% of staff within the CRMC health system are fully vaccinated, with another 1% partially vaccinated, President and CEO Tim Thornell said Tuesday. The hospital and Cheyenne Regional Medical Group combined have a total of about 2,100 employees.

Thornell said he expects that, as the deadline draws closer, more staff will choose to get vaccinated – a trend he said has been seen across the country. When medical facilities have imposed their own vaccine requirements, typically only about 0.5% to 2.5% of staff have remained unvaccinated, he said.

The hospital will likely receive “a handful” of exemption requests, and most will probably be granted, Thornell said. CRMC will form a committee to evaluate each request.

Thornell said staff who remain unvaccinated are represented in “a random smattering of people across different work groups.” For the portion who do leave or who are forced out, he expects the hospital to rely on temporary workers for the short term and recruit new employees in the long term.

“Certainly, we’ll be sad for any staff member that chooses to leave because of this, but we fully respect and understand their individual choice,” Thornell said. “And we’ll be here to welcome them back, too. If at some point in the near future they choose to want to return, we’re happy to have them back, as well.”

‘Nobody wants to lose their job’

Crystal Tafoya is one of CRMC’s employees who doesn’t plan to get the vaccine. The operating room nurse, who has worked at the hospital for more than 14 years, said she believes the vaccine should be a personal choice, and is “adamantly opposed to the government telling you what you need to put in your body.”

“It’s my job every day to advocate for patients, and I’m just torn to shreds that I can’t do that for myself,” she said, adding that she feels there should be more research on the side effects of the vaccine.

For its part, the hospital – as well as the Wyoming Department of Health, the U.S. Centers for Disease Control and Prevention, and the vast majority of local and national medical organizations – continues to assert that the currently approved COVID-19 vaccines are safe and effective at preventing hospitalization and death.

Tafoya said she feels the mandate has created a division among hospital staff.

“I’ve had staff members who I’ve worked with for almost 15 years that I just love like family say to me that I better not get sick with COVID and take up a bed from somebody who’s vaccinated, and I said to him, ‘How can you say that to me? We don’t get to cherry pick our patients like that,’” she said.

Tafoya estimated there are about 75 staff members who are angry about the mandate, but it remains to be seen who will decide to leave or potentially be let go.

“I realize that it comes down to how strongly people believe in this, and I also realize it’s very close to Christmas, and who wants to lose their job right before Christmas? Nobody,” she said. “Nobody wants to lose their job, anyway.”

Bob Shaffer, a pediatric certified nursing assistant, said he believes hospital staff have been “blackmailed” into receiving the vaccine. He said he’s quit jobs on principle before, and he doesn’t think it’s right for the government to require people to take what he calls an “experimental drug.”

Shaffer is hoping for a religious exemption, but if it’s not granted, he said he’s lucky enough to have other options.

Future of staffing unclear

As some health care workers are denied religious exemptions, Boley said facilities are beginning to see what it may look like for staff to leave en masse, including having to shut down services in some places.

“We’re going to be having a much more difficult time staffing. For those that refuse to get vaccinated, it’s going to create a real situation – not just here in our state, but across the country,” Boley said.

The U.S. is already experiencing a shortage of nurses and other health care workers, he said, and for those who don’t comply with the federal mandate, they’re unlikely to find health care jobs elsewhere.

While Tafoya said she understands medical centers like CRMC are in a difficult spot – comply with the mandate or risk crippling fines, loss of Medicare and Medicaid funds or decertification – she still wishes hospital administrators had taken a different approach.

“I guess I would have appreciated a different stance from our leadership here to say we’re not going to force staff members into this, we will fight for you, we will figure something out,” she said.

Thornell said CRMC has always asserted that hospital officials should be able to decide for themselves when a vaccine requirement is appropriate.

“We still would have preferred that, but we (hospital leadership) see the merits of it and have been pretty unified in our commitment to moving forward and being in compliance with the CMS guidelines for us,” he said.

Like Shaffer, Tafoya said she’s applied for a religious exemption. Beyond that, though, it’s difficult to know what her next steps will be.

“I don’t really have a plan,” she said. “I will try to get my exemption letter approved, and (I’m) praying that that works. And, if not, I guess I will have to weigh my options.”

Hannah Black is the Wyoming Tribune Eagle’s criminal justice reporter. She can be reached at or 307-633-3128. Follow her on Twitter at @hannahcblack.

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